What Is SDMA

ByGZMEDTECH

Evaluative dimethylarginine (SDMA) is a renal biomarker used to assess glomerular filtration rate for diagnosis, classification, and monitoring of chronic kidney disease. SDMA can diagnose and monitor diseases earlier than traditional renal biomarker testing capabilities.

Traditional renal diagnostics

1. Hematology Test

Routine blood test, as the most commonly used clinical examination item, has a very good prompting effect on the diagnosis of chronic renal failure. Chronic renal failure often leads to damage to kidney function, and the body’s production of erythropoietin (EPO) is significantly reduced. Erythropoietin is a very important regulatory factor for red blood cell regeneration. If the body lacks erythropoietin, the body cannot regenerate red blood cells normally, resulting in The body is anemic.

2. Biochemical Test

Biochemical test is currently the most commonly used examination method for clinical diagnosis of renal failure. Biochemical examination can evaluate renal function. When kidney function is damaged by more than 75%, creatinine and urea nitrogen will change significantly. Traditional chronic renal failure classification is also based on creatinine concentration. Because the clinical manifestations of many animals with renal failure are not obvious, biochemical examinations are often performed as routine disease screening for elderly animals. The concept of regular physical examinations for elderly animals has yet to be popularized, while the concept of medical examinations for humans has been deeply rooted in the hearts of the people. As a part of veterinary diagnosis and treatment, which is also a part of medical care, there is still a lot of room for improvement in this aspect.

3. Urine test

Urinalysis is an important diagnostic method for chronic renal failure. Animals with chronic renal failure may suffer from reduced renal function, loss of normal urine processing ability, decreased urine specific gravity, decreased urine osmotic pressure, decreased urine, and proteinuria. Sediment examination may reveal various casts, which are of great significance in the diagnosis of kidney disease. However, the current problem is that most pet hospitals do not pay attention to urine testing. Firstly, they lack the corresponding testing instruments, and secondly, the laboratory personnel are limited in their abilities and cannot conduct corresponding urine tests well.

4. Imaging examinations

Imaging examination is an important means of diagnosing chronic renal failure. Imaging mainly includes two aspects: X-ray and B-ultrasound. All are accompanied by renal atrophy.

5. UPC

The urine protein to urinary creatinine ratio, or UPC for short, is used to detect the amount of protein lost in urine and can detect very low protein levels in dog and cat urine. This method uses the ratio of urinary protein to urinary creatinine instead of simple urinary protein value, which can well avoid the impact of differences in urine volume and concentration of urine among different individuals on urinary protein quantification, so it can accurately reflect the loss of protein in urine. A good auxiliary indicator for kidney examination.

SDMA in Cats & Dogs

Kidney disease is common in dogs and cats; the reported incidence of kidney disease is 0.5%-7% in dogs and 1.6%-20% in cats. Depending on the dietary structure, breeding environment, local epidemics, regions, etc., there may be certain differences in dog and cat diseases in various regions. SDMA is a small molecule substance formed by methylation of arginine. It is released into the blood during protein degradation and is mainly excreted by the kidneys. With the deepening of research, more and more studies have shown that SDMA has an early diagnosis and follow-up monitoring role in reducing renal function for chronic kidney disease in dogs and cats, and can detect renal dysfunction in dogs and cats earlier than serum creatinine. Early diagnosis enables earlier nephroprotective intervention and delays the progression of kidney disease.

DOG

What is the difference between Creatinine and SDMA?

The traditional kidney function indicator creatinine is affected by muscle mass, but SDMA is not affected. For some sick animals with severe emaciation and muscle loss, SDMA is more reliable than creatinine. In addition, SDMA detects renal function abnormalities earlier than creatinine. Generally, creatinine will only increase when the kidney function is lost by more than 75%, while SDMA will become abnormal when the kidney function is lost by 40% on average. According to research, SDMA can detect chronic kidney disease in cats 48 months in advance and chronic kidney disease in dogs 27 months in advance.

What causes high levels of SDMA?

Causes of elevated SDMA may include kidney function problems, other diseases, or physiological conditions.

SDMA (symmetric dimethylarginine) is a measure of glomerular filtration rate, and elevated levels may indicate decreased glomerular filtration function. However, elevated SDMA does not necessarily mean kidney failure, as other factors such as excessive protein intake, inflammation, muscle damage, etc. may also cause elevated SDMA. Therefore, the interpretation of SDMA values ​​should comprehensively consider the clinical situation and other renal function indicators to obtain a more accurate diagnosis. In addition, elevated SDMA concentrations may also indicate impaired glomerular filtration rate (GFR), which may be due to primary kidney disease or secondary kidney damage, such as complications. By analyzing the causes of elevated SDMA concentrations, it is possible to determine whether acute, active, or chronic kidney injury has occurred and how to investigate, manage, and monitor kidney disease. Elevated levels of SDMA may be caused by a variety of factors, including kidney function problems and other diseases or physiological conditions. Therefore, the explanation of elevated SDMA requires a comprehensive consideration of multiple factors, and the diagnosis cannot be made based on SDMA levels alone.

What should you do if SDMA is high in Cats & Dogs?

Investigate, manage, and monitor after elevated SDMA

Investigation:

underlying causes:

  • UTI/ Pyelonephritis
  • Poisoning (e.g., nonsteroidal anti-inflammatory drugs, ethylene glycol, lily)
  • chronic kidney disease
  • systemic hypertension
  • CKD

Possible measures:

  • Urine Culture and Minimum Inhibitory Concentration (MIC) Test
  • Infectious Disease Screening
  • Abdominal imaging tests
  • UPC
  • Blood pressure

Evaluation of Concurrency Factors:

  • Hydration status
  • Cat’s thyroid status

Management:

Reasonable treatment:

  • Underlying disease (e.g., pyelonephritis, infectious disease)
  • dehydration
  • Discontinue nephrotoxic drugs (e.g., nonsteroidal anti-inflammatory drugs)
  • high blood pressure
  • proteinuria

adjuvant treatment:

  • Plenty of clean drinking water
  • Use kidney prescription food

Adjust anesthesia plan:

  • Infusion (intravenous or subcutaneous)
  • Oxygen supply before, during and after anesthesia
  • Adjust pain management plan

Monitor:

Monitoring below renal biomarkers:

  • SDMA/Urea ammonia/CREA/blood phosphorus
  • Urine test
  • Blood pressure

Prognosis:

SDMA remains elevated but stable:

  • GFR remains impaired but stable
  • Consider a diagnosis of CKD, refer to IRIS classification and treatment guidelines
  • Establish appropriate supportive care and monitoring programs

SDMA continues to rise:

  • persistent active kidney injury
  • Follow-up investigation: review or other diagnosis
  • Establish an ongoing supportive care plan

Final thoughts

It can quickly and accurately monitor the SDMA content in dogs and cats, with high accuracy, strong specificity, high sensitivity, wide testing range and stable performance.